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Please print or type. Form Approved.OMB No.2050-0039 <br /> UNIFORM HAZARDOUS WAST;MANIFEST 1.G erator u ey.,_ 22.P 23.�,M nif t racking Number <br /> Continuation Sheet / <br /> 24.Generator's Name <br /> � iib <br /> 25. Transport Company Name U.S.EPA ID N ber -r <br /> 26. Transporter CompanyName U.S.EPA ID Number <br /> 27a. 27b.U.S.DOT Description(including Proper Shipping Name,Hazard Class,ID Number, 28.Containers 29.Total 30.Unit <br /> HM and Packing Group(if any)) No. Type Quantity Wt./Vol. <br /> 31.Waste Codes <br /> O <br /> Q <br /> W <br /> Z <br /> W <br /> 0 <br /> I <br /> 32.Special Handling Instructions and Additional Information <br /> 33.Transpo er Acknowledgment of Receipt of Materials <br /> LLJ 1.— � <br /> Printed/Typed Signature Month Day Year <br /> of <br /> 3 L <br /> Z <br /> Z 34.Transporter _Acknowledgment of Receipt of Materials <br /> IPrinte y ed Name Si na(ure Mo Day Year <br /> IqlAIN <br /> ^ ' <br /> r 35 Discrepancy <br /> J_ <br /> U <br /> Q <br /> LL <br /> W <br /> a 36.Hazardous Waste Report Management Method Codes(i.e.,codes for hazardous waste treatment,disposal,and recycling systems) <br /> z <br /> C� <br /> Cn <br /> W <br /> 0 <br /> EPA Form 8700-22A(Rev.12-17) Previous editions are obsolete. DESIGNATED FACILITY TO EPA's e-MANIFEST SYSTEM <br />